An Interview with Clinica Verde Board Member and Former Minister of Health Margarita Gurdian.
Margarita Gurdian was Minister of Health of Nicaragua from 2004-2007. During that time she was in charge of the management of 1076 health units, 25,000 employees and a budget of $182 million US per year. She led the planning process for a National Health Policy for 2004-2015, a 5-year health plan and the Health Comprehensive Model of Care. She is currently doing work in Angola. Margarita received her B.A. in Latin American Studies at the University of California, Riverside, and an M.A. in Latin American Studies with a major in Public Health at the University of California, Los Angeles.
Q: How did you become involved with Clinica Verde?
A: After I left my post as Minister of Health I had a meeting with Susan Dix Lyon and Cristiana Chamorro, to see how could the effort that had started with Susan and her husband helping the Hospital in Boaco, could continue and help provide health quality services to a population with very few resources and a high rate of pregnancy in adolescents. Susan started organizing from scratch and her energy and motivation gave life to the project. I could not step aside. Susan's family was working so hard, the Board was enthusiastic and the proposed project to be a Green Clinic was an innovative, healthy and a tremendous challenge. Nicaragua is very lucky to have friends as Susan's family and all of the Board members.
Q: What about the project attracted you?
A: The fact that it does not matter where you are or if you are in the public or private sector, there is always a possibility of continuing supporting communities with very little resources in Nicaragua and try to provide quality health services as well as working on a healthy project that could be a model not only for Nicaragua but for other countries and communities as well. Also to work with a group of people whose only interest is doing good for people who need health services.
Q: As the former Minister of Health, what do you think Nicaragua's biggest challenge is in terms of improving healthcare for the impoverished?
A: I think that this is a challenge in we are all responsible for. All sectors must contribute to improving health care in our communities and in the country. A healthy population is a key determinant to development. Between 60-80% of the illnesses we have in Nicaragua are preventable. But also there are different factors that need improvement: one is budget. Nicaragua has people very well trained. Being in a country in Africa I can see the enormous difference in the availability of trained resources but the conditions in the rural areas in Nicaragua for trained professionals are not the best, therefore there is a migration of these more specialized human resources to the capital or bigger cities. Payment or salaries to attract health professionals are not high enough to keep them in the rural areas.
Another factor is attitude: if we put ourselves in the shoes of the people we are caring for, even if there are not enough drugs, equipment, people will feel that the provider is doing everything he or she can for them to feel better.
Q: Nicaragua has the highest rates of adolescent fertility in Latin America. What do you attribute this to and what can be done to change this number?
A: According to the DHL 50% of women under 19 are pregnant or already have a baby. Lack of information to youngsters at the schools and at home is a big part. Empower young women and work with them on alternative programs addressed to young women and men in a friendly and respectful environment where they can ask and receive answers to their concerns, their doubts and provide them with accurate information.
Q: Why should people in other parts of the world support Clinica Verde?
A: Clinica Verde is an innovative concept on how to provide quality health care, a holistic approach where you do not only see the individual that comes to the clinic looking for care but you work with the community, see the individual as part of a family and of a community. And this is a model that follows all norms and regulations to be friendlier with the environment and provide a sense of pride to the communities that will serve.
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